Journal of urban health : bulletin of the New York Academy of Medicine
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The primary aim of this paper was to explore whether provider's understanding of patient's social context is associated with screening uptake, independent of provider's recommendation. Baseline data were collected in 2004-2005 from a cluster randomized control trial in 12 low-income housing sites. Participants included 695 low-income, multiethnic adults aged 50 years and over who were primarily insured (97%). ⋯ Provider's understanding of patient's social context, as operationalized by how well participants felt that their provider knew (a) their responsibilities at work, home, or school; (b) their worries about health; and (c) them as a person and their values and beliefs, was also significantly associated with current adherence to screening, independent of provider's recommendation. Participants who reported that their provider knew them well on two or three items were significantly more likely to be current with CRC screening compared to those who reported their provider knew them well on only one or none of the items (odds ratio = 1.56; 95% confidence interval = 1.06, 2.29). Our findings indicate that provider's understanding of patient's social context, independent of provider's recommendation for CRC screening, contributed to adherence to CRC screening in this low-income, multiethnic population.
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Exposure to elevated levels of vehicular traffic has been associated with adverse cardiovascular and respiratory health effects in a range of populations, including children, the elderly, and individuals with pre-existing heart conditions, diabetes, obesity, and genetic susceptibilities. As these relationships become clearer, public health officials will need to have access to methods to identify areas of concern in terms of elevated traffic levels and susceptible populations. ⋯ The method is demonstrated with publically available information on susceptible populations, traffic volumes, and Traffic Analysis Zones, a transportation planning tool long used by Metropolitan Planning Agencies and planners across the USA but presented here as a new application which can be used to spatially assess possible traffic-related impacts on susceptible populations. Recommendations are provided for the appropriate use of this methodology, along with its limitations.
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Young men who have sex with men (YMSM) are among the highest risk groups for HIV, and the risk distribution varies by race/ethnicity. Prevalence rates are consistently higher for minority YMSM. ⋯ We examined disparities in HIV risk among a community-based sample of Black, Latino, and non-Hispanic Caucasian YMSM age 16-24. To address gaps in the literature, we examined factors between and within racial/ethnic groups across domains including: sexual and substance use behaviors, sexualized and other social contexts, psychological well-being, HIV attributes and prevention skills, and sexual minority stress.
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It is a common problem in India for women in the reproductive age group to suffer from reproductive illnesses and not seek care. This paper is an attempt to assess untreated reproductive morbidities and to study factors affecting treatment-seeking behavior among ever married women of urban slums. We selected 1,046 women of the reproductive age group (15-49 years) using two-stage cluster sampling for a community-based, cross-sectional study. ⋯ Providers' poor attitudes, poor quality of services, and long waiting times were found to be the reasons for not utilizing health facilities. The determinants for accessing reproductive health care were resources available at the household level, social factors, the availability of services, and behaviors related to health. Government facilities remained underutilized.